TERRAFORMING TERRA
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Thursday, December 8, 2011

Smoking Can Make Nipples Fall Off

This is a story that on first
blush is simply too good to be true.Yet
we all underestimate the effects of nicotine on blood flow generally and this
item makes it clear that the effect is far worse than one can imagine.

Obviously the nearby stress and inflammation
generated by the plastic surgery takes already compromised circulation over the
point of crisis and we have the horror of an unrecoverable collapse of
circulation at the extremities such as the nipple.

That we have leaches available to
solve this problem is one of the more amusing chapters in modern medicine.For years, it was thought that the method was
pure witchcraft and totally eliminated from medical practice, until someone
woke up to its application in wound healing.Now it is used routinely as are even maggots to clean dying wounds.Neither is a pleasant solution, but one uses
what actually works when a live needs to be saved.

Considering the onset of serious
circulatory issues in extremities as individuals succumb to diabetic
degeneration as they age, it actually makes good sense to apply blood letting
through application of leeches.Yet I suspect
it was applied poorly in the time and place, whatever the argument because no
underlying theory existed to support the process that directed application.

Plastic surgery is generally
dismissed as a safe but vain procedure.In practice it is anything but safe and as this item shows, the doctor
is also relying hugely on the patients cooperation.

Anthony Youn, M.D., is a plastic surgeon in Metro Detroit. He is the author of “In Stitches,” a humorous memoir
about growing up Asian American and becoming a doctor.

I cringe every time I see a patient for a breast lift who is a smoker.
I’m deathly afraid that despite my warnings, she will smoke before or after
surgery and cause her nipples to turn black and fall off.

Yes. Smokers who undergo breast lifts are at great risk of losing their
nipples.

I’ve seen it before.

The nicotine in cigarettes and the carbon monoxide contained in
cigarette smoke can diminish blood flow to various parts of the body. These
toxins act as a virtual tourniquet. If the blood flow to a particular body part
becomes greatly reduced or halted, that body part dies.

In my memoir “In
Stitches,” I told the story of a smoker whose nipples turned purple while
undergoing a breast lift surgery. Purple is the precursor to black. Black is
the precursor to falling off. To save the patient—and her nipples - we turned
to the only treatment available.

We went medieval.

We used leeches.

Because of the mechanics of blood flow, when the blood supply is
inadequate, which occurs with smoking, the tiniest veins often fail. This
insufficiency results in a backup of old (venous) blood in the body part,
causing it to turn purple. If the backup of old blood is serious enough, the
purple color may eventually turn black. That’s when we know the body part -
toe, finger, or nipple - is dead.

We use leeches to literally suck out the excess venous blood from the
body part, acting as an attachable vein. The leech drains the old blood,
causing it to turn from unhealthy purple back to healthy pink. We place leeches
intermittently until the body part grows new blood vessels to do the leeches’
work. This can take several days.

Not long ago, during a consultation for a breast lift, a patient,
Susan, admitted to being a pack-a-day smoker. I informed her that smoking can
cause difficulty in healing and instructed her to quit smoking at least one
month before surgery and to stay off cigarettes for at least a month afterward.
Several months later, when she arrived at the hospital for her breast lift, she
smelled like an ashtray.

“Susan, I thought you quit smoking.”

“I did. OK. For a while. It’s really hard to quit, Dr. Youn.”

“I know,” I said. “But this is a big deal. There could be major healing
problems if you smoke before or after surgery.”

“I understand. But I want to go ahead with the surgery anyway. It’ll be
fine.”

She wasn’t hearing me. I needed to get through to her. “Susan, listen
to me. If I operate on you, your nipples could turn black and fall off.”

Her eyes widened. “You mean… I’d have no nipples?”

“No nipples. That’s what smoking can do.”

Susan flushed. She raised her voice. “Dr. Youn, I took a week off work
for this surgery. I had to put my whole life on hold for an entire week. If you
told me I’d lose my nipples from smoking, I would’ve quit for good. This is your
fault.”

Yes. Seriously. Susan blamed me for the inconvenience.

Thanks to her, I’ve changed my policy. In addition to the Surgeon
General’s Warning that appears on cigarette packages, I now offer the Plastic
Surgeon’s Warning to all my patients who smoke: If you are having a breast lift
or reduction and you smoke, your nipples could turn black and fall off. If you
are having a tummy tuck and you smoke, you may get an infection resulting in a
big gross open wound that will take three months to heal. If you are having a
facelift and you smoke, the skin of your cheek could turn black and slough off,
leaving exposed fat.

Imagine yourself looking like “Two-Face” from “Batman: The Dark
Knight.”

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Apr 2017 - 4.1 Mil Pg Views, March 2013 - Posted my paper introducing CLOUD COSMOLOGY & NEUTRAL NEUTRINO rigorously described, September 2010 I am pleased to report that my essay titled A NEW METRIC WITH APPLICATIONS TO PHYSICS AND SOLVING CERTAIN HIGHER ORDERED DIFFERENTIAL EQUATIONS' has been published in Physics Essays(AIP) and appeared in their June 2010 quarterly. 40 years ago I took an honors degree in applied mathematics from the University of Waterloo. My interest was Relativity and my last year there saw me complete a 900 level course under Hanno Rund on his work in relativity,as well as differential geometry(pure math) and of course analysis. I continued researching new ideas and knowledge since that time and I have prepared a book for publication titled Paradigms Shift&. I maintain my blog as a day book and research tool to retain data and record impressions and interpretations on material read. Do join my blog and receive Four items of interest daily Monday through Saturday.